NCCN Guidelines for Patients® | Lung Cancer - Non-Small Cell Lung Cancer

60 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 Part 6 is a guide to the treatment options for cancer stages I, II and III. These cancers are called non-metastatic. Options are grouped by whether there is one or more unrelated tumors. Your doctor may suggest other options based on your health and wishes. Fully discuss your options with your doctor. Overview Primary tumors A primary tumor is the first mass of cancer cells. Cancer cells may break away from the primary tumor and form other tumors. These are called secondary tumors. A person can have more than one primary tumor. The histologic subtype may be the same or differ between the primary tumors. Multiple primary tumors may occur at the same time. They may occur in the same lung but different lobes or occur in both lungs. Multiple tumors may occur at different times. You may have been treated for one primary tumor and now have a second primary tumor. Treatment path Lung cancer is very often treated with more than one type of treatment. Treatments may be received in a sequence or at the same time. Some of the terms used in this book or by doctors are: † † Initial treatment is the first treatment received. It is often based on the clinical stage of the cancer. The clinical stage is the rating of the extent of cancer before treatment. † † Induction treatment is the first treatment received for some higher-staged cancers. The goal is to greatly reduce the extent of cancer. It consists of chemotherapy with or without radiation. If it works well, sometimes surgery becomes an option. † † Preoperative treatment is received before surgery. It is often given to shrink the cancer to make surgery easier. It is sometimes called neoadjuvant treatment. It may consist of chemoradiation or chemotherapy. † † Adjuvant treatment is given after local treatments to treat any remaining cancer. It consists of chemotherapy, radiation therapy, or both. It is partly based on the pathologic stage of cancer. This stage is a rating of the cancer after treatment. Sometimes, more cancer is found than first thought. † † Boost radiation is an extra dose of radiation. It is used to improve the results of treatment. † † Consolidation treatment is given to prolong the good results of prior treatment. For lung cancer, up to 12 months of durvalumab is used. 6 Non-metastatic cancer Overview